Cycle 1
Health 2025-03-13 · Fire 2025-03-13
5 health deficiencies
Top issue: Environmental (1 deficiency)
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
San Luis Obispo, CA
San Luis Post Acute Center
5-star overall rating with 5-star inspections with 5 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
3033 Augusta Street, San Luis Obispo, CA
(805) 544-5100
Overall
5 / 5
CMS overall stars
Health inspections
5 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
162
Certified beds
Average residents
82
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Compass Health, Inc.
Operator or chain grouping
Approved since
1972-02-29
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
7 facilities
Chain averages 5 overall / 5 health / 4 staffing / 5 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.38
Registered nurse staffing · state 0.65 · national 0.68
LPN hours / resident day
1.18
Licensed practical nurse staffing · state 1.22 · national 0.87
Aide hours / resident day
3.29
Nurse aide staffing · state 2.64 · national 2.35
Total nurse hours
4.85
All reported nurse hours · state 4.51 · national 3.89
Licensed hours
1.56
RN + LPN hours · state 1.87 · national 1.54
Weekend hours
4.29
Weekend nurse staffing · state 4.08 · national 3.43
Weekend RN hours
0.31
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.21
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.39
CMS adjusted RN staffing hours
Adjusted total hours
4.96
CMS adjusted total nurse staffing hours
Case-mix index
1.34
Higher values indicate more complex resident acuity
RN turnover
67%
Annual RN turnover · state 42% · national 45%
Total nurse turnover
50%
Annual nurse turnover · state 38% · national 46%
SNF VBP
Value-based purchasing
Program rank
755
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
64.21
Composite VBP score used to determine payment impact.
Payment multiplier
1.0188
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
8.93
Baseline 18.32% · Performance 17.29% · Measure score 8.93 · Achievement 8.93 · Improvement 7.44
Healthcare-associated infections
10
Baseline 5.62% · Performance 4.77% · Measure score 10 · Achievement 10 · Improvement 9
Total nurse turnover
2.08
Baseline 43.06% · Performance 55.17% · Measure score 2.08 · Achievement 2.08 · Improvement 0
Adjusted total nurse staffing
4.68
Baseline 4.04 hours · Performance 4.41 hours · Measure score 4.68 · Achievement 4.68 · Improvement 1.63
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 7.88% |
10.72%
2.8 pts better
|
Better than the National Rate · Eligible stays 273 · Observed rate 4.76% · Lower 95% interval 5.68% |
| Discharge to community | 66.69% |
50.57%
16.1 pts better
|
Better than the National Rate · Eligible stays 273 · Observed rate 64.1% · Lower 95% interval 61.67% |
| Medicare spending per beneficiary | 0.9 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 146 · Denominator 146 |
| Falls with major injury | 0.68% |
0.77%
0.1 pts better
|
Numerator 1 · Denominator 146 |
| Discharge self-care score | 55.28% |
53.69%
1.6 pts better
|
Numerator 68 · Denominator 123 |
| Discharge mobility score | 49.59% |
50.94%
1.3 pts worse
|
Numerator 61 · Denominator 123 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 146 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 4.77% |
7.12%
2.4 pts better
|
No Different than the National Rate · Eligible stays 144 · Observed rate 1.39% · Lower 95% interval 2.98% |
| Staff COVID-19 vaccination coverage | 32.11% |
8.2%
23.9 pts better
|
Numerator 35 · Denominator 109 |
| Staff flu vaccination coverage | 52.63% |
42%
10.6 pts better
|
Numerator 70 · Denominator 133 |
| Discharge function score | 47.97% |
56.45%
8.5 pts worse
|
Numerator 59 · Denominator 123 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 98 · Denominator 98 |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 21 · Denominator 21 |
| Resident COVID-19 vaccinations up to date | 49.33% |
25.2%
24.1 pts better
|
Numerator 37 · Denominator 75 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.8 |
2.3
1.5 pts better
|
1.9
1.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.1 |
1.6
0.5 pts better
|
1.8
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 0.9 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
98.5%
1.5 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
98.2%
1.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 0.0% |
1.6%
1.6 pts better
|
3.3%
3.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
6.8%
6.8 pts better
|
11.4%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who lose too much weight | 3.1% |
4.1%
1 pts better
|
5.4%
2.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.0% · Q2 6.1% · Q3 0.0% · Q4 1.8% · 4Q avg 3.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 22.6% |
13.7%
8.9 pts worse
|
19.6%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.0% · Q2 22.4% · Q3 20.9% · Q4 26.3% · 4Q avg 22.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 28.1% |
14.2%
13.9 pts worse
|
16.7%
11.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 27.8% · Q2 31.4% · Q3 26.7% · Q4 26.7% · 4Q avg 28.1% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.4%
0.4 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 2.9% |
11.0%
8.1 pts better
|
16.3%
13.4 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 2.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 1.6% |
10.7%
9.1 pts better
|
14.9%
13.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.6% · Q4 3.8% · 4Q avg 1.6% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
1.0%
1 pts better
|
1.0%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.5% |
1.2%
0.7 pts better
|
1.7%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 1.7% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 5.4% |
10.9%
5.5 pts better
|
19.8%
14.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 7.3% · Q3 3.9% · Q4 8.0% · 4Q avg 5.4% |
| Percentage of long-stay residents with pressure ulcers | 1.1% |
4.7%
3.6 pts better
|
5.1%
4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 1.7% · Q4 1.3% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
94.0%
6 pts better
|
81.7%
18.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 11.6% |
11.2%
0.4 pts worse
|
12.0%
0.4 pts better
|
Short Stay · 20240701-20250630 · Adjusted 11.6% · Observed 10.7% · Expected 10.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.5% |
1.5%
About the same
|
1.6%
0.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 2.4% · Q3 2.2% · Q4 0.0% · 4Q avg 1.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 100.0% |
93.2%
6.8 pts better
|
79.7%
20.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 13.0% |
23.2%
10.2 pts better
|
23.9%
10.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 13.0% · Observed 11.5% · Expected 20.9% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-01-18 · Fire 2024-01-18
2 health deficiencies
Top issue: Infection Control (1 deficiency)
3 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2021-05-14 · Fire 2021-05-14
9 health deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
3 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-03-13
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-03-24
E · Potential for more than minimal harm
2024-01-18
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2024-02-20
E · Potential for more than minimal harm
2024-01-18
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2024-02-20
D · Potential for more than minimal harm
2024-01-18
K531 · Services Deficiencies
Fire Safety
Have elevators that firefighters can control in the event of a fire.
Corrected 2024-02-20
D · Potential for more than minimal harm
2021-05-14
K223 · Egress Deficiencies
Fire Safety
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2021-06-08
D · Potential for more than minimal harm
2021-05-14
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2021-06-08
D · Potential for more than minimal harm
2021-05-14
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2021-06-08
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-11-13
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2025-11-14
D · Potential for more than minimal harm
2025-03-13
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2025-04-03
D · Potential for more than minimal harm
2025-03-13
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-04-03
D · Potential for more than minimal harm
2025-03-13
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-04-03
D · Potential for more than minimal harm
2025-03-13
F908 · Environmental Deficiencies
Health
Keep all essential equipment working safely.
Corrected 2025-04-03
F · Potential for more than minimal harm
2024-01-18
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-02-18
D · Potential for more than minimal harm
2024-01-18
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2024-02-18
D · Potential for more than minimal harm
2021-05-14
F552 · Resident Rights Deficiencies
Health
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F810 · Nutrition and Dietary Deficiencies
Health
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Corrected 2021-06-16
D · Potential for more than minimal harm
2021-05-14
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2021-06-16
Penalties and ownership
What sits behind the stars
Ownership
Compass Health Inc
5% Or Greater Direct Ownership Interest · Organization
Castillo, Carly
Operational/Managerial Control · Individual
Compass Health Inc
Operational/Managerial Control · Organization
Compass Holdings Inc
5% Or Greater Indirect Ownership Interest · Organization
Downey, Susan
Operational/Managerial Control · Individual
Gerrish, Nancy
5% Or Greater Indirect Ownership Interest · Individual
Gerrish, William
5% Or Greater Indirect Ownership Interest · Individual
Hodge, Timothy
Operational/Managerial Control · Individual
Hodge, Timothy
Corporate Officer · Individual
Mcmullen, Juanita
5% Or Greater Indirect Ownership Interest · Individual
Moya, Marie
Operational/Managerial Control · Individual
Moya, Marie
Corporate Director · Individual
Moya, Marie
Corporate Officer · Individual
Smith, Darren
Operational/Managerial Control · Individual
Smith, Darren
Corporate Director · Individual
Smith, Darren
Corporate Officer · Individual
Woolpert, Mark
5% Or Greater Indirect Ownership Interest · Individual
Woolpert, Patricia
5% Or Greater Indirect Ownership Interest · Individual
Woolpert, Patrick
Operational/Managerial Control · Individual
Woolpert, Patrick
Corporate Director · Individual
Nearby options
Other facilities in reach
#1
Mission View Health Center
San Luis Obispo, CA
5-star overall rating with 5-star inspections with 2 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#2
San Luis Transitional Care
San Luis Obispo, CA
5-star overall rating with 5-star inspections with 5 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
#3
Arroyo Grande Care Center
Arroyo Grande, CA
5-star overall rating with 5-star inspections with 3 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
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